CoChat
Sign Up
Cited by 34Diabetes Treatment and ManagementPharmacology and Obesity TreatmentIntestinal and Peritoneal Adhesions

The DOI matches its Crossref record; 4 of the 4 references it cites were found in a registry or an index.

Use of DPP4 Inhibitors and GLP-1 Receptor Agonists and Risk of Intestinal Obstruction: Scandinavian Cohort Study

Open access
Ueda, Peter, Wintzell, Viktor, Melbye, Mads, Eliasson, Björn, Söderling, Jonas, Gudbjörnsdottir, Soffia, Hveem, Kristian, Jonasson, Christian, Svanström, Henrik, Hviid, Anders, Pasternak, Björn·2024·Clinical Gastroenterology and Hepatology
DOI 10.1016/j.cgh.2023.08.034
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND & AIMS: Concerns have been raised that the incretin-based diabetes drugs dipeptidyl peptidase 4 (DPP4) inhibitors and glucagon-like peptide 1 (GLP-1) receptor agonists may increase the risk of intestinal obstruction. We aimed to assess the association between use of DPP4 inhibitors and GLP-1 receptor agonists and the risk of intestinal obstruction. METHODS: Using data from nationwide registers in Sweden, Denmark, and Norway, 2013-2021, we conducted 2 cohort studies, one for DPP4 inhibitors and one for GLP-1 receptor agonists, to investigate the risk of intestinal obstruction as compared with an active comparator drug class (sodium-glucose co-transporter 2 [SGLT2] inhibitors). RESULTS: Among 19,0321 new users of DPP4 inhibitors (median (interquartile range [IQR]) follow-up time, 1.3 [0.6-2.6] years) and 139,315 new users of SGLT2 inhibitors (median [IQR] follow-up time, 0.8 [0.4-1.7] years), 919 intestinal obstruction events occurred. Use of DPP4 inhibitors, as compared with SGLT2 inhibitors, was not associated with a statistically significant increase in risk of intestinal obstruction (adjusted incidence rate, 2.0 vs 1.8 per 1000 person-years; hazard ratio, 1.13; 95% confidence interval, 0.96-1.34). Among 121,254 new users of GLP-1 receptor agonists (median [standard deviation] follow-up time, 0.9 [0.4-1.9] years) and 185,027 new users of SGLT2 inhibitors (median [IQR] follow-up time, 0.8 [0.4-1.8] years), 557 intestinal obstruction events occurred. Use of GLP-1 receptor agonists was not associated with a statistically significant increase in risk of intestinal obstruction (adjusted incidence rate, 1.3 vs 1.6 per 1000 person-years; hazard ratio, 0.83; 95% confidence interval, 0.69-1.01). CONCLUSIONS: In this analysis of nationwide data from 3 countries, previous safety signals indicating an increased risk of intestinal obstruction with use of DPP4 inhibitors and GLP-1 receptor agonists were not confirmed.

Overview

Integrity signals

Registry

Crossref · 10.1016/j.cgh.2023.08.034

Cites

4 of 4 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In a study using nationwide registry data from Sweden, Denmark, and Norway involving 121,254 new GLP-1 RA users and 185,027 new SGLT-2 inhibitor users, there was no significant correlation between GLP-1 RA use and increased intestinal obstruction risk.

    “In contrast to these results, a study using nationwide registry data from Sweden, Denmark, and Norway—involving 121,254 new GLP-1 RA users and 185,027 new SGLT-2 inhibitor users— documented 557 intestinal obstruction events, with no significant correlation between GLP-1 RA use and increased intestinal obstruction risk, thereby refuting earlier safety concerns [12].”

    From Exploring the Side Effects of GLP-1 Receptor Agonist: To Ensure Its Optimal Positioning (2025) · cites this paper as [12]

Citations

Cites

Flagged first, then by citations

Research works printed but not linked: 24

  1. Andersen, 2018, Do we know the true mechanism of action of the DPP-4 inhibitors?, Diabetes Obes Metab, 20, 34, 10.1111/dom.13018 · DOI
  2. Drucker, 2018, Mechanisms of action and therapeutic application of glucagon-like peptide-1, Cell Metab, 27, 740, 10.1016/j.cmet.2018.03.001 · DOI · Paper page
  3. Kanasaki, 2013, Three ileus cases associated with the use of dipeptidyl peptidase-4 inhibitors in diabetic patients, J Diabetes Investig, 4, 673, 10.1111/jdi.12095 · DOI
  4. Shemies, 2022, Semaglutide induced gastric outlet obstruction: a case report, Teikyo Medical Journal, 45, 6743
  5. Holder, 2023, Intestinal obstruction, Surgery (Oxford), 41, 47, 10.1016/j.mpsur.2022.10.013 · DOI
  6. Gudin, 2020, Incretin-based drugs and intestinal obstruction: a pharmacovigilance study, Therapies, 75, 641, 10.1016/j.therap.2020.02.024 · DOI · Paper page
  7. Faillie, 2022, Incretin-based drugs and risk of intestinal obstruction among patients with type 2 diabetes, Clin Pharmacol Ther, 111, 272, 10.1002/cpt.2430 · DOI · Paper page
  8. D’Agostino, 2000, Estimating and using propensity scores with partially missing data, J Am Stat Assoc, 95, 749, 10.1080/01621459.2000.10474263 · DOI
  9. Stürmer, 2021, Propensity score weighting and trimming strategies for reducing variance and bias of treatment effect estimates: a simulation study, Am J Epidemiol, 190, 1659, 10.1093/aje/kwab041 · DOI
  10. Stürmer, 2014, Propensity scores for confounder adjustment when assessing the effects of medical interventions using nonexperimental study designs, J Intern Med, 275, 570, 10.1111/joim.12197 · DOI
  11. Sato, 2003, Marginal structural models as a tool for standardization, Epidemiology, 14, 680, 10.1097/01.EDE.0000081989.82616.7d · DOI
  12. Bennett, 2016, Association between therapy with dipeptidyl peptidase-4 (DPP-4) inhibitors and risk of ileus: a cohort study, Diabetol Int, 7, 375, 10.1007/s13340-016-0261-3 · DOI
  13. Harel, 2007, Multiple imputation: review of theory, implementation and software, Stat Med, 26, 3057, 10.1002/sim.2787 · DOI
  14. Ludvigsson, 2011, External review and validation of the Swedish national inpatient register, BMC Public Health, 11, 450, 10.1186/1471-2458-11-450 · DOI · Paper page
  15. Schmidt, 2015, The Danish National Patient Registry: a review of content, data quality, and research potential, Clin Epidemiol, 7, 449, 10.2147/CLEP.S91125 · DOI
  16. McMurray, 2019, Dapagliflozin in patients with heart failure and reduced ejection fraction, N Engl J Med, 381, 1995, 10.1056/NEJMoa1911303 · DOI · Paper page
  17. McDonagh, 2021, 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure, Eur Heart J, 42, 3599, 10.1093/eurheartj/ehab368 · DOI · Paper page
  18. Wettermark, 2007, The new Swedish Prescribed Drug Register: opportunities for pharmacoepidemiological research and experience from the first six months, Pharmacoepidemiol Drug Saf, 16, 726, 10.1002/pds.1294 · DOI · Paper page
  19. Pottegård, 2016, Data resource profile: the Danish National Prescription Registry, Int J Epidemiol, 46, dyw213, 10.1093/ije/dyw213 · DOI
  20. Ludvigsson, 2011, External review and validation of the Swedish national inpatient register, BMC Public Health, 11, 450, 10.1186/1471-2458-11-450 · DOI · Paper page
  21. Schmidt, 2015, The Danish National Patient Registry: a review of content, data quality, and research potential, Clin Epidemiol, 7, 449, 10.2147/CLEP.S91125 · DOI
  22. Ludvigsson, 2016, Registers of the Swedish total population and their use in medical research, Eur J Epidemiol, 31, 125, 10.1007/s10654-016-0117-y · DOI
  23. Schmidt, 2014, The Danish Civil Registration System as a tool in epidemiology, Eur J Epidemiol, 29, 541, 10.1007/s10654-014-9930-3 · DOI
  24. Arendt, 2020, Existing data sources in clinical epidemiology: laboratory information system databases in Denmark, Clin Epidemiol, 12, 469, 10.2147/CLEP.S245060 · DOI

Cited by

Sorted by citations

Metadata

Authors
Ueda, P., Wintzell, V., Melbye, M., Eliasson, B., Söderling, J., Gudbjörnsdottir, S., Hveem, K., Jonasson, C., Svanström, H., Hviid, A., & Pasternak, B.
Affiliations
  • Karolinska Institutet (SE)
  • University of Copenhagen (DK)
  • Sahlgrenska University Hospital (SE)
  • Norwegian University of Science and Technology (NO)
  • Statens Serum Institut (DK)
Corresponding author
Ueda, Peter
ORCID
Venue
Clinical Gastroenterology and Hepatology
Publisher
Elsevier BV
Published
2024-06
Volume
22
Issue
6
Pages
1226-1237.e14
ISSN
1542-3565 (ISSN-L)
DOI
10.1016/j.cgh.2023.08.034
OpenAlex
W4386781026
Cited by
34
References
4
Citations by year
2026: 13 · 2025: 15 · 2024: 6
FWCI
6.99
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Gastroenterology and Hepatology (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
Funders
  • Vetenskapsrådet
  • Novo Nordisk Fonden
  • Hjärt-Lungfonden
  • Karolinska Institutet
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Pharmacology (medical) › Pharmacology and Obesity Treatment
  • Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
Keywords
intestinal obstruction, DPP-4 inhibitors, GLP-1 receptor agonists, incretin-based therapy, SGLT2 inhibitors, type 2 diabetes, drug safety, adverse drug reactions
MeSH terms
Glucagon-Like Peptide-1 Receptor, Sodium-Glucose Transporter 2 Inhibitors, Glucagon-Like Peptide-1 Receptor Agonists, Adult, Aged, Denmark, Diabetes Mellitus, Type 2, Female, Humans, Intestinal Obstruction, Male, Middle Aged, Scandinavian and Nordic Countries, Sweden, Cohort Studies, Incidence, Risk Assessment, Dipeptidyl-Peptidase IV Inhibitors

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review